The impact of Mexidol on improving quality of life parameters and functional kidney status as part of complex therapy for cognitive impairments in comorbid patients with microalbuminuria against the background of arterial hypertension and type 2 diabetes mellitus

Objective. Evaluation of the effect of Mexidol as part of the complex therapy of cognitive impairment for 10 weeks on cognitive status, quality of life parameters and kidney function in comorbid patients with microalbuminuria on the background of arterial hypertension (AH) and type 2 diabetes mellitus (DM). Methods. The prospective, open randomized trial included 60 comorbid patients (1:1) with hypertension and type 2 diabetes with cognitive impairment< 24 points on the Montreal Cognitive Function Assessment Scale (MoCA) and microalbuminuria (urinary albumin/creatinine >30 mg/g). The average age of the patients was 64.8±10.3 years, 50% were male. 30 patients were included in the standard therapy group with additional administration of Mexidol (200 mg intramuscularly once a day for 14 days, then 125 mg 3 times a day for 8 weeks) and 30 patients in the standard therapy group. Initially and at the end of the study, the effect of therapy on the cognitive status of patients was assessed using the Montreal Cognitive Function Assessment Scale (MOCA), quality of life parameters based on the results of the Minnesota (MLHFQ), Kansas (Kansas City Cardiomyopathy Questionnaire, KCCQ) and the SF-36 questionnaire «Quality of Life Assessment», the severity and dynamics of asthenic syndrome according to the subjective asthenia assessment scale (MFI-20) and the level of anxiety on the Beck scale. Initially, after 14 days and at the end of the study, the functional state of the kidneys was assessed by serum creatinine and cystatin C, the estimated glomerular filtration rate of GFR by creatinine level (eGFRcr), eGFR by cystatin C level (eGFRCCcys) in the blood and the ratio of albumin/creatinine in urine. Results. Patients who received Mexidol in addition to standard therapy showed a significant improvement in cognitive function on the MoCA scale by 20% (p<0.001), an improvement in the quality of life according to the Minnesota questionnaire by 21% (p<0.001), according to the Kansas questionnaire by 12% (p=0.05), a decrease in the severity of asthenic syndrome by 18% (p<0.001) and anxiety levels by 41% (p<0.001), a significant improvement in the functional state of the kidneys in the form of a decrease in albuminuria by 71% (p<0.001), creatinine by 7.3% (p<0.01), cystatin C by 18% (p<0.001), increased eGFRcr by 8.7% (p<0.001), eGFRcys by 11.28% (p<0.001). Conclusion. Mexidol, when added to standard therapy in comorbid patients with microalbuminuria on the background of hypertension and type 2 diabetes, significantly improves cognitive status, quality of life parameters, reduces the severity of asthenic syndrome and anxiety levels, and improves the functional state of the kidneys.